多层螺旋CT及后处理技术在急性阑尾炎诊断中的价值

Value of multi-slice CT and its processing technique in the diagnosis of acute appendicitis

目的:探讨多层螺旋CT(MSCT)及图像后处理技术对急性阑尾炎的诊断价值。方法:67例临床拟诊为急性阑尾炎的病例行MSCT检查,并经工作站进行多层面重建(MPR)及曲面重建(CPR)图像后处理,分析其CT表现并与手术病理结果对照。结果:急性阑尾炎MSCT的主要征象有阑尾管腔直径增粗(直径>6mm)、管壁增厚38例,阑尾周围炎31例,阑尾结石19例,回盲部管壁肥厚15例,阑尾脓肿12例,阑尾炎性包块7例。MSCT对急性阑尾炎诊断的敏感性、特异性、准确度、阳性预测值、阴性预测值分别为95%、82%、93%、96%、75%。结论:急性阑尾炎有典型的CT表现。MSCT及图像后处理技术能多方位显示阑尾本身及其周围组织改变及合并症,可显著提高急性阑尾炎的术前诊断准确率。

Objective： To evaluate the value of multi-slice CT（MSCT） and its imaging processing technique in the diagnosis of acute appendicitis. Methods： Sixty-seven patients with clinically suspected appendicitis underwent preoperative contrastenhanced MSCT. Images were transferred to the workstation and then processed with muhiplanar reconstruction（MPR）, curved planar reformation（CPR）. The CT manifestations were analysed and compared with surgical and pathological findings. Results： The CT manifestations of acute appendicitis were an enlarged appendix in 38 cases, thickening of appendiceal wall in 31 cases, appendicolith in 19 cases, cecal apical thickening in 15 cases, appendiceal abscess in 12 cases, inflamatory mass in 7 cases. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MSCT in acute appendicitis were 95%, 82%, 93%, 96%, 75% respectively. Conclusion： MSCT can provide an advantage of showing the appendix multidirectionaly and improving the accuracy of diagnosis.